BACKGROUND AND OBJECTIVE: There is a documented connection between the home environment and health. Medical-legal partnerships (MLPs) can address social and environmental determinants of health. Our objective was to describe a cluster of substandard housing identified and treated by an MLP based in a pediatric primary care setting.
METHODS: Potential cases of poor-quality housing were identified during outpatient primary care. A case was defined as any rented housing unit with a reported unaddressed housing risk within a defined building portfolio (owned by a single developer) in which ≥1 child lived. An on-site MLP offered affected families legal services including ordinance enforcement and connection to resources. They also initiated portfolio-wide advocacy. Legal advocates reported case outcomes. Medical history and household demographics were collected from the medical record and compared with clinic-wide data by using Fisher’s exact test or χ2 statistics.
RESULTS: After identification of a single case, an additional 15 cases were identified. Pest infestation was the most common initial risk identified. Of 14 units with outcome data, repairs were completed in 10 (71%). Of the 19 building complexes with the same owner, 11 received significant systemic repairs. Of the 45 children living within the 16 identified case units, 36% had asthma, 33% had developmental delay or behavioral disorder, and 9% had an elevated lead level. Affected children were more likely to have one of these diagnoses than the general clinic population (all P < .01).
CONCLUSIONS: An MLP identified and improved home environmental conditions for children living in a cluster of substandard housing.
- Child HeLP —
- Cincinnati Child Health-Law Partnership
- EMR —
- electronic medical record
- HSHC —
- Hopple Street Health Center
- LASGC —
- Legal Aid Society of Greater Cincinnati
- MLP —
- medical-legal partnership
- PPCC —
- Pediatric Primary Care Center
- SDH —
- social determinants of health
- Accepted July 6, 2012.
- Copyright © 2012 by the American Academy of Pediatrics